This invention relates generally to pelvic floor exercises, and more specifically to devices and methods that can quantify pelvic floor diagnostic findings and monitor and improve pelvic floor strength.
Disorders of pelvic support are a significant health care concern, resulting in the loss of billions of dollars annually. Associated with the rigors of childbirth, trauma, and the aging process, these disorders not only result in financial loss, but have a profound emotional component often altering one""s self image as well. The resultant loss in function and self-esteem associated with such disorders is often extremely debilitating, leading to prolapse, discomfort, and both urinary and sexual dysfunction.
To combat these disorders, a variety of therapeutic approaches have been entertained. Both non-surgical and surgical techniques have been utilized with varying degrees of success. While surgical management certainly has its role, it is not without risk and expense. Medical management likewise must be carefully individualized, requiring thorough surveillance by the prescribing physician.
With this in mind, non-operative therapies to enhance the support of pelvic tissues are highly desirable. Traditionally, supportive devices such as the pessary or specialized pelvic floor exercises, commonly referred to as Kegel exercises, have been the mainstay of therapy. While pessaries provide artificial support to pelvic floor musculature, Kegel exercises help strengthen such tissues. Patients are trained to utilize isometric contractions of the pubococcygeus and levator ani muscles to strengthen the pelvic floor musculature and thus improve function. Utilization of such exercises requires training and motivation, and variations of such methodology have been successfully utilized and proven with respect to the ability to overcome stress incontinence.
Several investigators have confirmed the benefits of such non-operative therapies, both subjectively and objectively. Two studies by Henalla, et al, published in the British Journal of Obstetric and Gynecology in 1988 and 1989, demonstrated improvement in two-thirds of patients utilizing such closely monitored therapy. The later study showed such exercises to be even more beneficial than both electrical stimulation of the pelvic floor and estrogen supplementation. Studies such as that of Tchou, et al, published in the 1988 Journal of Physical Therapy confirmed such outcomes utilizing urodynamic evaluations, both prior to and after pelvic floor exercise therapy. In a variation of this theme, Peattie, et al, published in the British Journal of Obstetric and Gynecology in 1988, utilized weighted vaginal cones to provide resistance with which pelvic muscle contraction could be taught, musculature strengthened, and function restored.
Critical to the success of such therapy is an understanding of how best to perform these exercises correctly, considering that when proper technique is not utilized, the potential for a worsening of function also exists. In one study by Bump, et al, published in the American Journal of Obstetric and Gynecology in 1991, less than half of those given either verbal or written instructions were able to illicit an ideal Kegel effort as demonstrated by an increase in the force of urethral closure.
With these principles and concepts in mind, it is clear that non-operative means are proven to be successful in improving the function of the pelvic floor. Such techniques may be learned and, as such, the ability to perform them properly is critical to achieving the outcome desired. It is these aforementioned concepts which have spawned desire to improve upon the non-operative techniques that have traditionally been utilized to improve pelvic floor function and further alleviate the need for both medical and surgical therapies.
The prior art demonstrates electronic and pneumatic pelvic floor exercise devices, e.g., Sawchuck U.S. Pat. No. 5,733,230 and Sample U.S. Pat. No. 5,674,238, spring-biased exercise devices, e.g., Wallick U.S. Pat. No. 5,865,715, heated and vibrating mechanism exercise devices, e.g., Benderev U.S. Pat. No. 5,782,745, and exercise devices utilized external to the body, e.g., Harris U.S. Pat. No. 5,531,226. However, the prior art poses the threat of further injury to the patient attributed to malfunction of the electronic, thermal, vibrating or pneumatic. Additionally, the complexity of the prior art diminishes reliability, in that numerous moving parts introduce a higher likelihood for malfunction. Finally, the prior art requires multiple apparatus for the performing both the diagnosis and treatment of pelvic floor injuries.
In order for pelvic floor disorders to be properly and efficiently diagnosed, it is highly desirable to provide a non-operative method for both physician and patient diagnosis, as well as a hygienic and reliable diagnostic tool that is easy to use in private, as an alternative to traditional procedures which can be inaccurate, cumbersome and embarrassing. In order for pelvic floor disorders to be properly and efficiently treated, it is highly desirable to provide a method and device allowing patients to perform exercise treatment in private, with self-governed frequency, in a simple and hygienic manner, and in any environment.
The disadvantage of the prior art are overcome by the present invention, and an improved pelvic floor exercise device and methods for pelvic floor musculature dysfunction diagnosis and treatment is hereafter disclosed.
The present invention provides a device for diagnosing and treating pelvic floor dysfunction which, in one embodiment, combines both the traditional approach of Kegel exercises and an innovation utilizing attractive magnets. This technique allows for several advantages over the existing technology, in that magnets may be calibrated so as to allow the patient to more properly learn the techniques associated with successful treatment. Further, the patient may follow personal progress, objectively demonstrating improvements in the strength of one""s pelvic floor musculature. This invention offers advantages over the prior art in that performing exercise with the device is not postural based, since the magnets may be calibrated so that exercises may be performed in a reproducible and progressive manner regardless of body habitus and positioning. This invention also offers patient safety and the anti-microbial benefits of magnet associated therapies, benefits not offered by prior art.
The magnetic attraction between a magnetic head and barrier may provide a biasing feature against which the contracting pelvic floor musculature may react. The head and barrier may be so magnetized as to provide a constant and reproducible attractive force between the head and the barrier, a force which may be calibrated via magnet and material selection. The head may be secured by thread engagement to a metal shaft. The shaft may have a measuring indication along a portion of a length of the shaft, may pass through the approximate center of the barrier. The head may have a generally semi-spherical shaped upper end and a generally conical lower end. The barrier may have a generally hourglass shaped barrier as to provide proper placement of the device in relation to the patient""s body. The lower end of the shaft may be secured by thread engagement to a handle to prevent the separation of the barrier from the shaft. The contraction of the pelvic floor musculature may move the head away from the stationary barrier, such that the shaft may slide upwards through the barrier. As the shaft slides through the barrier, an indicator opposite the barrier from the head may slide down the shaft, indicating the degree to which the head has traveled from its initial position when the pelvic floor musculature was at rest. This indication feature is a primary objective of this invention. The feature allows the physician and patient to measure the strength of the pelvic floor musculature.
The magnetic head may be detachable from the device shaft in such a manner that it may be reattached to a pin. The pin may provide an attach point for a lanyard to the magnetic head. Once the head is detached from the device and reattached to the lanyard, the patient may repeat the above pelvic floor musculature contraction procedure using only the head and lanyard, as opposed to the entire device. In this manner, the patient may continue to exercise the pelvic floor musculature in a private, self-paced manner, thereby increasing the strength of the pelvic floor musculature.
In another embodiment, magnets are mounted on plates, and are configured to repel each other and thus the attraction of the plates. Movement of the bulb away from the plate which serves as the barrier is thus resisted by the magnets.
In yet another embodiment, a flexible elastomeric member may be slid over the bulb and held in position against a single plate by a screw cap. Movement of the bulb away from the plate is resisted by the elastomeric member, which is stretched during use of the pelvic floor exercise device.
It is an object of this invention to provide a pelvic floor exercising device comprising a shaft, a measuring indication along a portion of a length of the shaft, a head secured to an upper end of the shaft, and a barrier moveably mounted on the shaft. It is a related object to provide such a device that provides hygienic, safe, reproducible and private diagnosis and rehabilitation.
It is a feature of the present invention that the device may provide a combination of magnetically attractive head and barrier components on a mutual shaft having a measuring indication. The barrier may have a substantially hourglass shaped configuration. It is a further feature that the barrier and the indicator may slide along a portion of the length of the shaft. Magnets may also be mounted on a pair of plates, with the magnets configured to repel each other. It is a further feature that the head may be detached from the shaft and thereafter attached to a pin and lanyard.
Yet another embodiment of the invention uses the elastomeric properties of a generally tubular closed end elastomeric member for resisting movement of the bulb or head away from a base plate. This embodiment also has advantages due to easy lubrication, ease of keeping the device clean, and a device wherein both the distance (stroke length) and force required to move that stroke length are easily variable.
It is an advantage of the present invention that the pelvic floor exercise device is relatively simple in design and construction, and is highly reliable. It is an additional advantage that magnets offer an advantage over the aforementioned utilization of weighted vaginal cones in strengthening the pelvic musculature, in that performing such exercise is no longer postural based. Regardless of both body habitus and positioning, magnets may be calibrated so that exercises may be performed in a reproducible and progressive manner. In this way, outcomes and process can be prospectively followed by the physician and patient alike.
It is a further advantage of the present invention that magnet associated therapies have an anti-microbial benefit shown in other venues, and that such therapy may provide improvements not only in function, but in the vaginal milieu as well. This advantageous feature is particularly of interest in the perimenopausal and postmenopausal population in which both of these disorders are more prominent.
It is a further advantage that an alternative to medical and/or surgical therapies with respect to the dilemma of pelvic floor dysfunction is provided by the apparatus, which may significantly improve upon an already existing non-surgical modality, and which has been proven and desired.
These and further objects, features and advantages of the present invention will become apparent from the following detailed description, wherein references are made to the figures in the accompanying drawings.